What New Mothers Need to Know: Perspectives from Women and Providers in Georgia


Identifying the educational and resource needs of new mothers is of paramount importance in developing programs to improve maternal and child health outcomes. The primary purpose of this study was to explore the educational needs of new mothers and identify opportunities to enhance healthcare providers’ current educational efforts. A two-part methodology was utilized to qualitatively explore the topic of parenting information needs for new mothers in Georgia. Data collection included information from 11 focus groups with 92 first-time, new mothers and 20 interviews with healthcare providers who serve new mothers. Discussions with both new mothers and providers clearly indicated that new mothers face a significant informational deficit, especially regarding very basic, daily infant care information and health literacy challenges. Educational materials already exist; however, mothers report difficulty accessing and understanding this information. For this reason, both the mothers and the providers stressed a focus on developing programs or interventions that allow in-person education and/or alternative modalities to access information, as opposed to development of new written materials solely. Information from the focus group and interviews provided important insight regarding what improvements need to be made to help new mothers and their families during the early stages of parenthood. By improving the education of new mothers and their families, it is proposed that maternal and infant health status could be improved.

This is a preview of subscription content, access via your institution.


  1. 1.

    Kanotra, S., D’Angelo, D., Phares, T. M., et al. (2007). Challenges faced by new mothers in the early postpartum period: An analysis of comment data from the 2000 pregnancy risk assessment monitoring system (PRAMS) survey. Maternal and Child Health Journal, 11(6), 549–558.

    PubMed  Article  Google Scholar 

  2. 2.

    Tiedje, L. B., Schiffman, R., Omar, M., et al. (2002). An ecological approach to breastfeeding. MCN, The American Journal of Maternal Child Nursing, 27(3), 154–162.

    Article  Google Scholar 

  3. 3.

    Bartick, M., Edwards, R. A., Walker, M., et al. (2010). The Massachusetts baby-friendly collaborative: Lessons learned from an innovation to foster implementation of best practices. Journal of Human Lactation, 26(4), 405–411.

    PubMed  Article  Google Scholar 

  4. 4.

    Bakermans-Kranenburg, M. J., van Ijzendoorn, M. H., & Bradley, R. H. (2005). Those who have, receive: The Matthew effect in early childhood intervention in the home environment. Review of Educational Research, 75(1), 1–26.

    Article  Google Scholar 

  5. 5.

    El-Mohandes, A. A. E., Katz, K. S., El-Khorazaty, M. N., et al. (2003). The effect of a parenting education program on the use of preventive pediatric health care services among low-income, minority mothers: A randomized, controlled study. Pediatrics, 111(6), 1324–1332.

    PubMed  Article  Google Scholar 

  6. 6.

    Chung-Park, M. S. (2012). Knowledge, opinions, and practices of infant sleep position among parents. Military Medicine, 177(2), 235–239.

    PubMed  Article  Google Scholar 

  7. 7.

    Gatti, L. (2008). Maternal perceptions of insufficient milk supply in breastfeeding. Journal of Nursing Scholarship, 40(4), 355–363.

    PubMed  Article  Google Scholar 

  8. 8.

    Persad, M. D., & Mensinger, J. L. (2008). Maternal breastfeeding attitudes: Association with breastfeeding intent and socio-demographics among urban primiparas. Journal of Community Health, 33(2), 53–60.

    PubMed  Article  Google Scholar 

  9. 9.

    Sussner, K. M., Lindsay, A. C., & Peterson, K. E. (2008). The influence of acculturation on breast-feeding initiation and duration in low-income women in the US. Journal of Biosocial Science, 40(5), 673–696.

    PubMed  Article  Google Scholar 

  10. 10.

    Tamis-LeMonda, C. S., & Kahana-Kalman, R. (2009). Mothers’ views at the transition to a new baby: Variation across ethnic groups. Parenting: Science and Practice, 9(1–2), 36–55.

    Article  Google Scholar 

  11. 11.

    Burd, L., Peterson, M., Face, G. C., et al. (2007). Efficacy of a SIDS risk factor education methodology at a Native American and Caucasian site. Maternal and Child Health Journal, 11(4), 365–371.

    PubMed  Article  Google Scholar 

  12. 12.

    Chung, E. K., Hung, Y. Y., Marchi, K., et al. (2003). Infant sleep position: Associated maternal and infant factors. Ambulatory Pediatrics, 3(5), 234–239.

    PubMed  Article  Google Scholar 

  13. 13.

    Corwin, M. J., Lesko, S. M., Heeren, T., et al. (2003). Secular changes in sleep position during infancy: 1995–1998. Pediatrics, 111(1), 52–60.

    PubMed  Article  Google Scholar 

  14. 14.

    Pickett, K. E., Luo, Y., & Lauderdale, D. S. (2005). Widening social inequalities in risk for sudden infant death syndrome. American Journal of Public Health, 95(11), 1976–1981.

    PubMed Central  PubMed  Article  Google Scholar 

  15. 15.

    Alexander, A., Dowling, D., & Furman, L. (2010). What do pregnant low-income women say about breastfeeding? Breastfeed Medicine, 5(1), 17–23.

    Article  Google Scholar 

  16. 16.

    Hanson, M. B., Hellerstedt, W. L., Desvarieux, M., et al. (2003). Correlates of breast-feeding in a rural population. American Journal of Health Behaviour, 27(4), 432–444.

    Article  Google Scholar 

  17. 17.

    Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: Coming of age. Annual Review of Public Health, 32, 381–398.

    PubMed  Article  Google Scholar 

  18. 18.

    Flores, G., Olson, L., & Tomany-Korman, S. C. (2005). Racial and ethnic disparities in early childhood health and health care. Pediatrics, 115(2), e183–e193.

    PubMed  Article  Google Scholar 

  19. 19.

    Jackson, C., & Dickinson, D. M. (2009). Developing parenting programs to prevent child health risk behaviors: A practice model. Health Education Research, 24(6), 1029–1042.

    PubMed Central  PubMed  Article  Google Scholar 

  20. 20.

    Wambach, K. A., & Koehn, M. (2004). Experiences of infant-feeding decision-making among urban economically disadvantaged pregnant adolescents. Journal of Advanced Nursing, 48(4), 361–370.

    PubMed  Article  Google Scholar 

  21. 21.

    Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic Status and Child Development. Annual Review of Psychology, 53, 371–399.

    PubMed  Article  Google Scholar 

  22. 22.

    Jones, T. L., & Prinz, R. J. (2005). Potential roles of parental self-efficacy in parent and child adjustment: A review. Clinical Psychology Review, 25(3), 341–363.

    PubMed  Article  Google Scholar 

  23. 23.

    Donovan, W., Taylor, N., & Leavitt, L. (2007). Supplemental material for maternal self-efficacy, knowledge of infant development, sensory sensitivity, and maternal response during interaction. Developmental Psychology, 43(4), 865–876.

    PubMed  Article  Google Scholar 

  24. 24.

    Doucet, F., & Hamon, R. (Eds.) (2007). A nation of diversity: Demographics of the United States of America and the implications for families. 1st edn. Cultural diversity and families: Expanding perspectives. Thousand Oaks: Sage Publications.

  25. 25.

    Reich, S. (2005). What do mothers know? Maternal knowledge of child development. Infant Mental Health Journal, 26(2), 143–156.

    Article  Google Scholar 

  26. 26.

    Reich, S. M., Penner, E. K., & Duncan, G. J. (2011). Using baby books to increase new mothers’ safety practices. Academic Pediatric, 11(1), 34–43.

    Article  Google Scholar 

  27. 27.

    Agency for Healthcare Research and Quality US Department of Health and Human Services. (2012). National Health Disparities Report 2011. Rockville 2012.

  28. 28.

    Mathews, T. J., & MacDorman, M. F. (2010). Infant mortality statistics from the 2006 period linked birth/death data set. US Department of Health and Human Services Vital Statistics Reports; 2010.

  29. 29.

    United Health Foundation America’s Health Rankings—2011 Edition. United Health Foundation. 2011. http://www.americashealthrankings.org/. Accessed Oct 13, 2012.

  30. 30.

    MacDorman, M. F., & Mathews, T. J. (2009). The challenge of infant mortality: Have we reached a plateau? Public Health Reports, 124(5), 670–681.

    PubMed Central  PubMed  Google Scholar 

  31. 31.

    Woolf, S. H., & Braveman, P. (2011). Where health disparities begin: The role of social and economic determinants—and why current policies may make matters worse. Health Affairs, 30(10), 1852–1859.

    PubMed  Article  Google Scholar 

  32. 32.

    Hannan, J. (2013). APN telephone follow up to low-income first time mothers. Journal of Clinical Nursing, 22(1–2), 262–270.

    PubMed  Article  Google Scholar 

  33. 33.

    Beal, A. C., Kuhlthau, K., & Perrin, J. M. (2003). Breastfeeding advice given to African American and white women by physicians and WIC counselors. Public Health Reports, 118(4), 368–376.

    PubMed Central  PubMed  Article  Google Scholar 

  34. 34.

    Miller, N. K., Verhoef, M., & Cardwell, K. (2008). Rural parents’ perspectives about information on child immunization. Rural and Remote Health, 8(2), 863.

    PubMed  Google Scholar 

  35. 35.

    Mesich, H. M. (2005). Mother-infant co-sleeping: Understanding the debate and maximizing infant safety. MCN: American Journal of Maternal/Child Nursing, 30(1):30–37; quiz 8–9.

    Google Scholar 

  36. 36.

    DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2003). Do perceived attitudes of physicians and hospital staff affect breastfeeding decisions? Birth, 30(2), 94–100.

    PubMed  Article  Google Scholar 

  37. 37.

    Deave, T., Johnson, D., & Ingram, J. (2008). Transition to parenthood: The needs of parents in pregnancy and early parenthood. BMC Pregnancy Childbirth, 8, 30.

    PubMed Central  PubMed  Article  Google Scholar 

  38. 38.

    Vannice, K. S., Salmon, D. A., Shui, I., et al. (2011). Attitudes and beliefs of parents concerned about vaccines: Impact of timing of immunization information. Pediatrics, 127(Suppl 1), S120–S126.

    PubMed  Article  Google Scholar 

  39. 39.

    Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks: Sage.

    Google Scholar 

  40. 40.

    Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oaks: Sage.

    Google Scholar 

  41. 41.

    NVivo Qualitative Data Analysis Software (2012). QSR International Pty Ltd. Version 10.

  42. 42.

    Richards, L. (2009). Handling qualitative data: A practical guide. Thousand Oaks: Sage Publications.

    Google Scholar 

  43. 43.

    Blake, S., Thompson, W., Corboy, L., et al. Breastfeeding support for new mothers: Patient and provider perspectives (submitted).

  44. 44.

    Gaydos, L., Woodruff, W., Blake, S., et al. Revisiting safe sleep recommendations: Why warnings without cultural context are not sufficient (submitted).

  45. 45.

    Baldwin, K. (2006). Comparison of selected outcomes of Centering Pregnancy versus traditional prenatal care. Journal of Midwifery & Women’s Health, 51(4), 266–272.

    Article  Google Scholar 

  46. 46.

    Rising, S. S. (1998). Centering pregnancy: An interdisciplinary model of empowerment. Journal of Nurse-Midwifery, 43(1), 46–54.

    CAS  PubMed  Article  Google Scholar 

  47. 47.

    Grady, M. A., & Bloom, K. B. (2004). Pregnancy outcomes of adolescents enrolled in a Centering Pregnancy program. Journal of Midwifery and Women’s Health, 49(5), 412–420.

    PubMed  Article  Google Scholar 

  48. 48.

    Klima, C. (2003). Centering pregnancy: A model for pregnant adolescents. Journal of Midwifery and Women’s Health, 48(3), 220–225.

    PubMed  Article  Google Scholar 

  49. 49.

    Novick, G. (2004). Centering Pregnancy and the current state of prenatal care. Journal of Midwifery and Women’s Health, 49(5), 405–411.

    PubMed  Article  Google Scholar 

  50. 50.

    Covington-Kolb. S. (Ed.) (2012). Centering pregnancy research program: Greenville Hospital System. Improving Infant Health Through the Lens of Centering Pregnancy; 2012; Atlanta, GA.

  51. 51.

    Kermani, R. M., Zoljalali, S., Azari, A., et al. (2007). The role of training workshops of newborn cares in promotion of mothers’ knowledge. Iran Journal of Pediatrics, 17, 41–46.

    Google Scholar 

  52. 52.

    Rising, S. S., & Kennedy, H. P. (2004). Redesigning prenatal care through Centering Pregnancy. Journal of Midwifery Women’s and Health, 49(5), 398–404.

    Article  Google Scholar 

  53. 53.

    Evans, W. D., Abroms, L. C., Poropatich, R., et al. (2012). Mobile health evaluation methods: The Text4baby case study. Journal of Health Communication, 17(Suppl 1), 22–29.

    PubMed  Article  Google Scholar 

  54. 54.

    Gazmararian, J. A., Yang, B., Elon, L., et al. (2012). Successful enrollment in Text4Baby more likely with higher health literacy. Journal of Health Communication, 17(Suppl 3), 303–311.

    PubMed  Article  Google Scholar 

  55. 55.

    Jordan, E. T., Ray, E. M., Johnson, P., et al. (2011). Text4Baby: Using text messaging to improve maternal and newborn health. Nursing for Women’s Health, 15(3), 206–212.

    PubMed  Article  Google Scholar 

  56. 56.

    Evans, W. D., Wallace, J. L., & Snider, J. (2012). Pilot evaluation of the text4baby mobile health program. BMC Public Health, 12(1), 1031.

    PubMed Central  PubMed  Article  Google Scholar 

  57. 57.

    Green, M. K., Dalrymple, P. W., Turner, K. H., et al. (2013). An enhanced text4baby program: Capturing teachable moments throughout pregnancy. Pediatric Nursing, 28(1), 92–94.

    Article  Google Scholar 

  58. 58.

    Whittaker, R., Matoff-Stepp, S., Meehan, J., et al. (2012). Text4baby: Development and implementation of a national text messaging health information service. American Journal of Public Health, 102(12), 2207–2213.

    PubMed  Article  Google Scholar 

  59. 59.

    Parker, R. M., Dmitrieva, E., Frolov, S., et al. (2012). Text4baby in the United States and Russia: An opportunity for understanding how mHealth affects maternal and child health. Journal of Health Communication, 17(Suppl 1), 30–36.

    PubMed  Article  Google Scholar 

Download references


This study was funded by the Georgia Department of Public Health, Office of Maternal and Child Health. Special thanks to Jonathan Hawley, Lauren Corboy and Whitney Woodruff for their assistance. We would also like to express our gratitude to staff at the various recruitment sites for their assistance in scheduling and accommodating the focus group sessions at the sites. Most of all, we are indebted to all of the mothers and providers who participated in this project by sharing their time, perceptions and experiences with us.

Author information



Corresponding author

Correspondence to Julie A. Gazmararian.


Appendix 1

See Table 4.

Table 4 Focus group discussion guide

Appendix 2

See Table 5.

Table 5 Provider Interview Guide

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gazmararian, J.A., Dalmida, S.G., Merino, Y. et al. What New Mothers Need to Know: Perspectives from Women and Providers in Georgia. Matern Child Health J 18, 839–851 (2014). https://doi.org/10.1007/s10995-013-1308-8

Download citation


  • Mothers
  • Infant
  • Health education
  • Health knowledge